Perirectal Oncologic Gateway to Retroperitoneal Endoscopic Single-Site Surgery (PROGRESSS)

Abstract

Perirectal oncologic gateway to retroperitoneal endoscopic single-site surgery for left-sided colonic resections using both flexible and rigid surgical endoscopic platforms was feasible and reproducible in an acute porcine model. This technique might represent a step toward pure NOTES left-sided colorectal procedures.

Endoluminal surgical triangulation: overcoming challenges of colonic endoscopic submucosal dissections using a novel flexible endoscopic surgical platform: feasibility study in a porcine model

“…1). This device has been used at our institute to perform a series of experimental hybrid NOTES procedures [12], and it has been successfully used in the clinical setting for transvaginal cholecystectomy [13].…”

“…All procedures were performed by a laparoscopic surgeon with *30 h' experience with the Anubiscope in procedures such as gastric ESDs in both pig and cadaver models, cholecystectomies in the pig model, and transrectal retroperitoneoscopic NOTES procedures [12] assisted by an endoscopist. The submucosal injection was performed by inserting the needle through the central 3.2-mm channel.…”

Transanal natural orifice transluminal endoscopic surgery total mesorectal excision in animal models: endoscopic inferior mesenteric artery dissection made easier by a retroperitoneal approach

“…A retroperitoneal endoscopic approach has been used as a transanal NOTES TME procedure [20], a method similar to ours for complete retroperitoneal mobilization of the left colon and mesenteric vessels without entering the abdominal cavity. That study, however, used a novel endoscopic surgical platform (IsisScope, Karl Storz) or laparoscopic instruments to dissect the IMA and retrieve lymph nodes.…”

Robotic surgery

“…The authors are developing two flexible endoscopic platforms (Anubiscope® for NOTES and Isisscope® for LESS; Karl Storz, Tuttlingen, Germany). These endoscopic platforms are provided with a bivalve tip that opens once in the peritoneal cavity, with flexible instruments passing through working channels and exiting in a triangulated fashion. Two ergonomic handles control the instruments, allowing the endoscopic surgeon to operate with both hands and to perform microsurgical sutures and endoluminal surgery (such as endoscopic submucosal dissection).…”